湖北省胃肠外科医师围手术期静脉血栓栓塞症预防理念现状分析

Analysis on the current situation of perioperative venous thromboembolism prevention among gastrointestinal surgeons in Hubei Province

目的分析湖北省胃肠外科医师围手术期静脉血栓栓塞症(VTE)预防理念现状。方法2020-06-01—2020-06-20华中科技大学同济医学院附属协和医院对湖北省胃肠外科联盟医师进行问卷调查。问卷内容包括基本信息、VTE预防理念、术前VTE预防现状、术后VTE预防现状及抗凝药物使用情况等。结果收集有效问卷509份,参与医师来自湖北省15个市(州)的112家医院。387名医师表示日常工作中使用VTE风险评分工具,其中55.6%的医师使用Caprini评分,1.6%的医师围手术期全程评估病人VTE风险。397名医师表示术前会对病人行药物预防,其中15.6%的医师对>50%的病人行药物预防;389名医师表示术后会对病人行药物预防,其中48.8%的医师对>50%的病人行药物预防。25.1%(128/509)的医师表示术前对病人同时行D-二聚体及下肢多普勒超声血管检查,15.3%(78/509)术后对病人监测D-二聚体及下肢多普勒超声血管检查。16.5%(84/509)的医师表示对VTE高危病人出院后进行足疗程低分子肝素治疗。结论湖北省胃肠外科医师已具备一定的VTE预防理念,但部分医师在围手术期VTE评估、药物预防及检查方面仍存在诸多不足。

Objective To investigate the current situation of the prevention on perioperative venous thromboembolism(VTE)among gastrointestinal surgeons in Hubei Province.Methods A questionaire survery was conducted among surgeons of the Hubei Gastrointestinal Surgery Union between June 1,2020 to June 20,2020.The questionaire was designed based on basic information,the understanding of VTE prevention,the current situation of perioperative VTE prevention and the use of anticoagulants.Results A total of 509 valid questionnaires were retrieved.Participating surgeons came from 112 hospitals in 15 cities(prefectures)in Hubei Province.Of the 387 surgeons who indicated using the VTE risk scoring tool on their routine,55.6%chose the Caprini Score and 1.6%assessed the VTE risk of patients during the perioperative period whole-process.Three hundred and ninety-seven surgeons indicated that drug prophylaxis would be given to patients before surgery,of which 15.6%would use drug prophylaxis for over half of patients.Three hundred and eighty-nine surgeons would use drug prophylaxis for patients after surgery,and 48.8%of them would use for over half of patients.25.1%(128/509)of the surgeons indicated that D-dimer together with lower extremity Doppler ultrasound venous examination were performed before surgery,and 15.3%(78/509)would monitor D-dimer and lower extremity Doppler ultrasound venous examination after surgery.16.5%(84/509)of the surgeons indicated that they would give a full course of low molecular heparin therapy to patients at high risk of VTE after discharge.Conclusion Gastrointestinal surgeons in Hubei Province have developed a certain concept of VTE prevention,but some surgeons still have deficiencies in perioperative VTE evaluation,drug prophylaxis and examination.